Photodynamic Therapy Using Topical Methyl Aminolevulinate vs Surgeryfor Nodular Basal Cell Carcinoma

Rhodes, Lesley E.; Rie, Menno A. de; Enström, Ylva; Groves, Richard; Morken, Tore; Goulden, V.; Wong, Gary; Grob, Jean-Jacques; Varma, Sandeep; Wolf, Peter

doi:10.1001/archderm.140.1.17

Cited by 328 publications

(291 citation statements)

References 25 publications

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“…PDT clearance rates for BCC, although being slightly lower than those observed with the standard treatments (standard surgery or cryotherapy), are not statically significantly different from the clearance rates achieved with these most commonly applied BCC treatment modalities [6,7] (with an average clearance rate of 87% for superficial BCC [8]). Efficacy for the thicker nodular subset of BCCs however appears to be inferior to standard treatments unless prior de-bulking or repeated PDT treatments are performed [5,9].…”

Section: Introductionmentioning

confidence: 68%

Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma

Pye

Campbell

Curnow

2008

J Cancer Res Clin Oncol

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Purpose:Methyl-aminolevulinate (MAL) photodynamic therapy (PDT) is a cancer therapy that combines the selective accumulation of a photosensitizer in tumor tissue with visible light (and tissue oxygen) to produce reactive oxygen species. This results in cellular damage and ablation of tumor tissue. Combining iron chelators with MAL has the potential to increase the accumulation of the photosensitizer protoporphyrin IX (PpIX) by reducing its bioconversion to heme. This paper investigates this method of enhancement both in vitro and for the first time clinically for the treatment of nodular basal cell carcinoma (BCC). Methods:Enhancement of MAL-induced PpIX accumulation by the iron chelator CP94 was quantified fluorometrically in human cultured cells (including three dermatological cell types). An open, dose-escalating, pilot study was then conducted in patients with nodular BCC, to determine the safety of this pharmacological modification. Results:Large enhancements in PpIX accumulation were observed in the cultured cells when coincubated with the iron chelator CP94. Clinically the addition of CP94 was found to be feasible and safe. In addition greater reductions in tumor depth were observed in the CP94 coincubated tumors. Conclusion:Iron chelation by CP94 is an effective enhancer of MAL-induced PpIX accumulation in vitro.

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Section: Introductionmentioning

confidence: 68%

Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma

Pye

Campbell

Curnow

2008

J Cancer Res Clin Oncol

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“…ALA-induced fluorescence has been used not only for diagnosis but also for treatment. In nodular basal cell carcinoma, PD therapy (PDT) using methyl aminolevulinate cream is effective (17). The complete response rate of clinically assessed lesion clearance did not differ significantly between the PDT group and the surgically-treated group (17).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative photodynamic diagnosis of lymph node metastasis in esophageal cancer patients using 5-aminolevulinic acid

et al. 2015

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Abstract. Lymph node metastasis is the strongest prognostic factor in esophageal cancer patients who have undergone esophagectomy. The accurate diagnosis of lymph node metastasis is important, but the pre-operative diagnostic accuracy is poor. The intraoperative diagnosis based on histopathological examination of frozen tissue specimens is complicated and time-consuming. Therefore, the establishment of a simple and rapid intraoperative diagnostic method is essential. Exogenous application of 5-aminolevulinic acid (ALA) causes a selective accumulation of protoporphyrin IX, which is a fluorescent substrate, in cancer cells. The present study evaluated the feasibility of photodynamic diagnosis using ALA (ALA-PDD) for lymph node metastasis in esophageal cancer. A total of 292 lymph nodes were analyzed from 8 esophageal squamous cell cancer patients treated with esophagectomy. The patients were administered ALA orally prior to surgery. Excised lymph nodes were cut in half and examined by spectrometer. The diagnostic results of ALA-PDD were compared to those of the histopathological examination. Among the 292 lymph nodes, 19 nodes (6.5%) were histologically metastatic and 21 nodes (7.2%) were PDD-positive. The sensitivity and specificity of ALA-PDD were 84.2% (16/19) and 98.2% (268/273), respectively. The area of cancer nests of the PDD-negative lymph nodes was <2 mm 2 . Metastatic lymph nodes, including cancer nests >4 mm 2 , were correctly diagnosed by ALA-PDD. In conclusion, this study demonstrated that ALA-PDD of lymph node metastasis in patients with esophageal cancer is feasible. Further investigation would make this method a simple and rapid intraoperative diagnostic tool.

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“…For nodular BCC a study comparing MAL PDT with surgical excision in 101 patients showed a MAL PDT cure rate of 76% compared to 96% for surgical excision. Cosmetis result was better for PDT with 87% of patients rated as good cosmetic outcome in comparison to 54% for surgery (Rhodes et al, 2004). When undergoing PDT, patients often complain of stinging, burning, and itching at the site of treatment.…”

Section: Photodynamic Therapymentioning

confidence: 96%

Basal Cell Carcinoma

Tuzun¹,

Kutlubay²,

Engın³

et al. 2011

Skin Cancer Overview

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Photodynamic Therapy Using Topical Methyl Aminolevulinate vs Surgeryfor Nodular Basal Cell Carcinoma

Cited by 328 publications

References 25 publications

Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma

Enhancement of methyl-aminolevulinate photodynamic therapy by iron chelation with CP94: an in vitro investigation and clinical dose-escalating safety study for the treatment of nodular basal cell carcinoma

Intraoperative photodynamic diagnosis of lymph node metastasis in esophageal cancer patients using 5-aminolevulinic acid

Basal Cell Carcinoma

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